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Under the National Health Fund’s Individual Benefits Programmes some 217,228 claims were satisfied between April 2004 and March this year. Some 77,773 claims were billed for the NHF card and 139,455 for the Jamaica Drug for the Elderly Programme (JADEP), both of which fall under the NHF’s Individual Benefits Programme.
Based on information contained in the NHF’s 2005 annual report, which was tabled in the House of Representatives yesterday (November 15) a total of 156,117 beneficiaries have been enrolled under the Individual Benefits Programme with 53,512 beneficiaries for the NHF card and 102,605 for JADEP.
The NHF health card provides assistance to all persons residing in Jamaica who have any of 15 chronic illnesses covered by the Fund, regardless of age or gender. Patients are able to use their NHF card to receive a subsidy when purchasing over 800 prescribed medications. The JADEP card provides 72 drugs free of charge to persons 60 years and older for the treatment of 10 chronic illnesses.
In the meantime there were two significant changes to the administration of subsidies in November 2004.
Initially 553 drug presentations were subsidized by the NHF card. In February of 2004 the Medical Review Committee undertook a comprehensive review of the subsidy list and made substantial changes. This saw the number of drugs covered increased by 73 and the number of presentations supported from 553 to more than 800. During the year monthly claims volume increased nine-fold from less than 5,000 to more than 45,000.
Meanwhile 73 NHF providers were added and 171 pharmacies signed new contracts with the NHF to become JADEP providers. This brings the total provider pharmacies to 220 or 67 percent of the 321 registered pharmacies. There are plans to next year to increase the coverage of provider pharmacies for each benefit category to at least 50 per cent of registered pharmacies in each parish.
According to the report, the enrolment of beneficiaries will remain a major initiative for the foreseeable future, buffered by the new strategies which have been implemented to increase enrollment.
One such initiative began with Cornwall Regional Hospital in January where the NHF intends to deal with the backlog of patients already registered with clinics and health centres but not enrolled with JADEP and NHF. This will be extended to the other Regional Health Authorities in the coming year.
Other strategies to be utilized include the establishment of customer services desks in the Health Regions, improving JADEP benefits, targeting human resource practitioners, and increasing health promotion programmes.